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Are you constantly worried about how close you are to a bathroom? Or do you fear that your irritable bowel syndrome (IBS) symptoms will strike and you'll have an embarrassing accident in public? If your fears about your IBS symptoms are starting to take over your life, it may be time for you to consider cognitive-behavioral therapy (CBT).

Cognitive-Behavioral Therapy for IBS: What Is It?

“Cognitive-behavioral therapy is based on the idea that thoughts affect behavior, and that by changing thinking, we can change behavior,” says Cynthia Radnitz, PhD, a clinical psychologist and professor of psychology at Fairleigh Dickinson University in New Jersey.

CBT isn't one specific therapy but rather a group of similar types of therapy involving behaviors, emotions, and thinking. CBT typically doesn't take as long as other forms of therapy — in as few as 10 sessions, patients can learn to address the thoughts that are triggering their fears, in hopes of preventing IBS symptoms.

In medical conditions, including IBS, "where psychological factors influence the problem, psychological interventions can help in terms of reducing symptoms," says Radnitz.

How Does Cognitive-Behavioral Therapy Help with IBS?

The exact cause of IBS is not known; there is no identifiable abnormality or inflammation in the gastrointestinal tract. And while many people with IBS also experience anxiety, the condition is a real physical problem. But if you can learn to control the anxiety that may trigger the physical reaction of diarrhea, constipation, abdominal cramping, or gas, you might be able to control or prevent those physical IBS symptoms.

"There's something about the way thinking affects physiology which is associated with irritable bowel syndrome," says Radnitz. "Fears of being too far from a bathroom and having an accident or fears of passing gas in public make them anxious. The therapy involves examining those kinds of thoughts and trying to help people think about it differently so they are not as anxious, and consequently IBS symptoms can be reduced."

CBT can teach patients with IBS how their mind and body are connected, and that they have control over how their mind and body can react. "It changes the way you think — it's realizing that your thoughts affect the way that you feel," says Radnitz.

CBT encourages IBS patients to consider what they were thinking about at the time that they experienced their symptoms. Therapists using CBT will also have IBS patients examine whether their fears are based on evidence, or just their own personal fears that they have created — in other words, are they rational, realistic fears?

“Some of the fears people develop regarding IBS symptoms arise from distorted thoughts — for example, that there is a high probability that they will have an accident, when in fact this has never happened." says Radnitz.

A therapist will work with patients with IBS to help them understand that their body will physically react to their thoughts, and how fear and anxiety may worsen their IBS symptoms. But the opposite is also true — controlling that fear and anxiety can actually help improve IBS symptoms. CBT "focuses on thoughts and how they are connected with IBS symptoms," notes Radnitz.

Cognitive-Behavioral Therapy for IBS: Who Can It Help?

You won't know if CBT can help you until you try it. CBT doesn't work for everyone, but some people have found it very helpful in managing their IBS symptoms. If you are constantly afraid or worried about having an accident in public or about IBS ruining your meeting, your dinner, or your vacation, learning how to control those fears using CBT might be helpful.

For help finding a therapist trained in CBT, you can contact the Academy of Cognitive Therapy or the Association for Behavioral and Cognitive Therapies.